Sugar-sweetened beverages may help colorectal cancer spread by changing how tumor cells use energy Digest
Sugar-sweetened beverages are linked to a higher risk of developing colorectal cancer, but their impact on how the disease progresses after cancer onset is less clear. To address this, scientists tested whether the two main sugars found in soft drinks—glucose and fructose—directly promote the spread of colorectal cancer to the liver, and what biological processes could explain it.
The researchers used human colorectal cancer cells, lab-grown mini-tumors, and mouse models of metastasis. They compared what happened when the cells and animals were exposed to a mixture of glucose and fructose (which reflects high‑fructose corn syrup or sucrose) with exposure to glucose alone.
You just missed this in your inbox
Every other week our Premium Members received this exact study plus Rhonda's practical commentary and 8+ other hand-picked papers.
The addition of fructose to glucose altered colorectal cancer cell behanvior:
- In cell culture experiments, glucose plus fructose made certain colorectal cancer cell lines move and invade through a barrier more readily, while their growth rate stayed the same.
- In mice, the same sugar mix caused more liver tumors to form, even though the original intestinal tumors were unchanged in size.
- The effect depended on an enzyme called sorbitol dehydrogenase, or SORD, which helps cells convert sugars into other molecules.
- Tumors from people with colorectal cancer had higher SORD levels than normal colon tissue, particularly in higher‑grade tumors and in some metastatic cohorts.
- Disabling SORD in cancer cells stopped the sugars from promoting spread. Mice given SORD-deficient cells developed far fewer liver tumors, despite the same sugar exposure.
- Inside cells, glucose and fructose together caused SORD to work in reverse, turning fructose into sorbitol and increasing a chemical balance known as the NAD⁺ to NADH ratio, which controls how cells process energy.
- This change sped up energy metabolism and activated the mevalonate pathway, a chain of reactions that makes cholesterol and other fat-related molecules that help cancer cells move and spread. Drugs called statins, which block this pathway, reduced metastasis in the mice.
When tumor cells rely on glucose alone, their main energy pathway, called glycolysis, can slow down because they run low on a molecule called NAD⁺. Adding fructose appears to change that. Through the enzyme SORD, fructose is converted into sorbitol, in a reaction that restores NAD⁺. This renewal of NAD⁺ allows glycolysis to continue efficiently, allowing the cells to draw more energy and carbon building blocks from glucose. Those extra resources can then feed into other pathways that help cancer cells move and spread.
The study was done in cells and animals, so it does not prove the same effect happens in humans. Still, it offers a biological explanation for how frequent intake of sugar-sweetened beverages could worsen colorectal cancer. The authors suggest that limiting such drinks may reduce colorectal cancer mortality or metastasis risk, and that drugs targeting SORD or the pathways it controls could one day help slow cancer spread. In this clip, Peter Attia goes in depth on cancer and explains why aggressive screening is essential.